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NPI Code Detail

MEDICARE: DARLEANE WILSON PA-C

MEDICARE: DARLEANE WILSON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant102532NC

General Provider Information

NPI Number : 1972513307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARLEANE WILSON PA-C
Provider Business Mailing Address
First Line : PO BOX 124
Second Line :
City : TOWNSVILLE
State : NC
Zip : 27584-0124
Country : US
Telephone Number : 252-432-5750
Fax Number : 252-430-7352
Provider Business Practice Location Address
First Line : 4600 CAPITAL BLVD
Second Line :
City : RALEIGH
State : NC
Zip : 27604-4478
Country : US
Telephone Number : 919-980-7008
Fax Number : 919-336-4528
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 03/30/2026

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Directions to “ DARLEANE WILSON PA-C” Practice Location

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